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Dr. L. K.S. Tiwari

MBBS

Cardiologist, Delhi

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Dr. L. K.S. Tiwari MBBS Cardiologist, Delhi
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To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. L. K.S. Tiwari
Dr. L. K.S. Tiwari is a renowned Cardiologist in Apex Citi Hospital, Delhi. He studied and completed MBBS . You can visit him at Apex Citi Hospital in Apex Citi Hospital, Delhi. Save your time and book an appointment online with Dr. L. K.S. Tiwari on Lybrate.com.

Lybrate.com has an excellent community of Cardiologists in India. You will find Cardiologists with more than 31 years of experience on Lybrate.com. You can find Cardiologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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D-440, West Vinod Nagar, Hanuman Road, Landmark: Near Nazzir Hotel, DelhiDelhi Get Directions
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D-440, West Vinod Nagar, Hanuman Road, Landmark: Near Nazzir Hotel.Delhi Get Directions
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I am 22 years old male. I am in habit of smoking therefore I feel pain in my heart. Please suggest me.

MBBS
General Physician, Cuttack
I am 22 years old male. I am in habit of smoking therefore I feel pain in my heart. Please suggest me.
1. Pain in the chest could be because of lung infection or heart problem due to smoking. Get plain x ray chest done and take ecg. 2. Consult physician with reportfor advice and treatment. 3. Stop smoking.
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He snore a lot while sleeping is there any problem will arise due to this, will it affect to heart or its due to aging ,is daily exercise is ok or have to do any thing more, any homemade solution is there?

BAMS, MD Ayurveda
Sexologist, Lonavala
He snore a lot while sleeping is there any problem will arise due to this, will it affect to heart or its due to agin...
As per your concern i would suggest you to do following remedy 1. Take 1 glass warm water 2. Crush some cardamom seeds to get ½ tsp cardamom powder 3. Add it to the water 4. Mix well 5. Consume every day at bedtime Causes: • During sleep, muscles in the mouth relax • At times, the tongue falls back • This obstructs the passage of air which leads to snoring • External factors which cause snoring are: o Physical exertion o Consuming alcohol o Certain medicines surely you will get results
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I'm a chain smoker and for the past few days I am facing lots of chest pains. What should I do to relief it?

MBBS
General Physician, Cuttack
I'm a chain smoker and for the past few days I am facing lots of chest pains. What should I do to relief it?
1.For your age pain chest could be due to anxiety, stress,Physical and mental strain, hyper acidity or muscle pull 2. Avoid stress and strain 3.Do regular exercise, Yoga, Meditation, deep breathing exercise like pranayama etc. It will calm your mind, control your emotion and relieve stress 4 Avoid Alcohol, smoking and tobacco consumption. 5.Take paracetamol 500mg one tablet sos after food up to a maximum of three tablets daily, at the time of chest pain.6. Drink plenty of water and take rest .7.if you have recurrent attack of chest pain take ECG and consult cardiologist
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Screening for Prehypertension

MD - General Medicine, MBBS
General Physician, Karimnagar
Screening for Prehypertension

Guidelines for vary from time to time, but generally accepted classification of hypertension ( JNC7)is

Average of two or more properly measured readings at each of two or more visits after an initial screen:

Normal                  < 120 mm Hg SBP             AND   DBP < 90 mm Hg

Prehypertension    120 -139 mm Hg SBP     OR      DBP 80 to 89 mm Hg

Stage 1 HTN            140 -159 mm Hg SBP     OR      DBP 90 to 99 mm Hg

Stage 2 HTN            >/= 160 mm of Hg SBP   OR     DBP >/= 100 mm Hg.

Prevalence of prehypertension among adults in United States is approximately 37 percent.

Study done by Yadhav S et al showed prevalence of prehypetension was 32.3 percent in India with highest  36% among 30-39 yrs age group, indicates that awareness is necessary for regular blood pressure check up.

People diagnosed with hypertension represents “tip  of an iceberg”.

Many patients get to know about their raised blood pressures at the time of diagnosis, heart attack, stroke or kidney disease( end organ failures) which would have been preventable  if treated at an early stage.

Why hypertension should be diagnosed and treated ?

Hypertension currently causes  2/3rd s of all strokes and half of all cases of ischemic heart disease.

Reduction in high blood pressure leads to large reduction in stroke, heart failure, renal failure, aortic dissection, coronary events and death.

Prehypertension: It is an entity where SBP >120 -139 mm Hg or DBP 80-89 mm Hg.

Multiple epidemiological studies demonstrated increased cardiovascular risk in patients with prehypertension.People with prehypertension have increased risk of progression to sustained hypertension, the prevalence of hypertension increases from approximately 10 percent at age of 30 yrs to as high as 90 percent after age of 65 yrs.

Framinham hypertension risk prediction score, may help identification of prehypertensive patients who are at gretest risk for pregression to hypertension. Risk calculator includes variables like age, sex, family history of hypertension, body mass index and smoking.  Most important predictors of these were higher baseline blood pressure and older age.

Screening for hypertension: optimal interval for screening is not known.

2007 USPSTF( United States Preventive Services Task Force) guidelines recommend

Screening every    two years for persons with SBP <120 mm Hg and DBP < 80 mm Hg     

                                 Yearly for persons with SBP 120-139 mm Hg or a DBP 80 -89 mm Hg

How to manage Prehypertension:

TROPHY stydy( TRial Of preventing Hypertension)  results showed that there is no role for pharmacotherapy in prehypertension except in special conditions like diabetes, chronic kidney disease etc.

Treatment:As per JNC 7 reccomendations patients with prehypertension who do not have diabetes, chronic kidney disease , end organ damage , or clinical evidence of cardiovascular disease are generally treated with non pharmacological therapies.

Major non pharmacological therapies that aid to decrease blood pressure are: 

Weight reduction:  Maintain normal body weight ( BMI 18.5 to 24.9 kg/m2)  this can reduce BP by 5 to 20 mm hg per 10kg weight loss.

Adopt DASH eating plan : (DASH- Dietary Approach To Stop Hypertension) consists of fruits, vegetables, legumes, low-fat dairy products with reduced saturated and total fat.This can reduce BP by 8 to 14 mm Hg.

Dietary sodium Restriction: Reduce dietary sodium intake to no more than 100meq/day(2.4 gm sodium or 6 gm of sodium chloride). This can reduce BP by 2 to 8 mm Hg.

Physical activity: Engage in a regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of the week). This can reduce BP by 4 to 9 mm Hg.

Moderation of alcohol: Limit consumption of alcohol to no more than 2 drinks per day in most men and no more than 1 drink in women and lighter weight persons. This can reduce BP by 2 to 4 mm Hg.

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My bp reading is170/102. I need to low my bp. Without medicine.

Certified Diabetes Educator, Registered Dietitian (RD), PGDD, Bachelor of Unani Medicine and Surgery (B.U.M.S), General Physician
Dietitian/Nutritionist,
My bp reading is170/102. I need to low my bp. Without medicine.
Dietary and other lifestyle changes can help you control and prevent high blood pressure. Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm hg. This eating plan is known as the dietary approaches to stop hypertension (dash) diet. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and total fat. If you're overweight, losing even 3 kgs can lower your blood pressure. Strive for at least 30 minutes of physical activity a day. I being a both a registered dietitian (rd) and doctor have been successfully helping patients with their problems through a holistic approach using customized therapeutic diet and medications. I will also suggest home remedies. Do reply back for private consultation for rx.
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15 years back he had open heart surgery and now his age s 30 , will he face any problem in future.

Diploma in Obstetrics & Gynaecology, MBBS
General Physician, Delhi
15 years back he had open heart surgery and now his age s 30 , will he  face any  problem in future.
No, his life will be healthy if he uses precautions about prevention of heart disease like all of us do-proper diet & exercise, no smoking & no negative stress & less salt /sugar despite bp & blood sugar levels in normal range.
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I have a pain in my chest and in back and my bones are getting unbalance it moves from its position. please sir give me some tips?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have a pain in my chest and in back and my bones are getting unbalance it moves from its position. please sir give ...
Postural correction- sit tall, walk tall. Extension exercises x 15 times x twice daily. Apply hot fomentation twice daily. Avoid bending in front.
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What should I do in my heart pain and what medicine I should take and how it will be wirk.

PGDCC, MD(Chest), PG Dip.Clin.Cardiology
Pulmonologist, Ghaziabad
What should I do in my heart pain and what medicine I should take and how it will be wirk.
It is chest pain and not the heart pain but you may be correct, get your ecg and x ray done after a doctor's consultation. Heart pain will increase on any kind of exertion and mostly radiate (spread) to arm or jaw etc. Sweating profusely and sinking feeling are common with heart pain. You cannot tell with a finger where it is (heart pain)?-dr maithili mohan tripathi md, pgdcc.
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Hello sir/madam I am 46 years old male person 3 years back i was met major accident and also I was in coma 20 days now I am ok but few ago am feeling bad about my legs are swelling when I was sleep in night, morning its clear by evening same problem reflected, I have only hypertension. No diabetic now I am using amplodine 5mg mor, evng 2.5 ramiprill please tell whats problem, every test normal -lipid profile-lft etc.

DM - Cardiology, MD - Internal Medicine, MBBS
Cardiologist, Delhi
Hello sir/madam I am 46 years old male person 3 years back i was met major accident and also I was in coma 20 days no...
In some individuals , amlodipine can cause swelling in the feet . Stop amlodipine and ramipril and start tab olmezest H 20mg once daily .. Hope the swelling goes . You should consult after one week of change in medications
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Is 90\60 low blood pressure?

MBBS, MD - Consultant Physician
General Physician,
It is normal blood pressure on the lower side, less than 90 is low say systolic 80 mm hg. Blood pressure can vary from 90/60 on the lower side upto 130/90 on the higher side.
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I am 63 year old male, suffering from high B P ie 150/100 and this happened only few days back say 7-10 days and still it is high till today.

BHMS
Homeopath, Faridabad
I am 63 year old male, suffering from high B P ie 150/100 and this happened only few days back say 7-10 days and stil...
Hello, Few lifestyle changes can help you in controlling and preventing the high blood pressure, even if you're taking blood pressure medication. Eat healthy foods. Consume more fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Eat less saturated fat and trans fat. Decrease the salt in your diet. So, avoid eating processed foods, such as canned soups or frozen dinners which contains extra salt in it. Keeping a healthy weight, or losing weight if you're overweight or obese, can help you control your high blood pressure and lower your risk of related health problems. Increase physical activity which can help lowering your blood pressure, manage stress, reduce your risk of several health problems. Get indulged in regular exercising (if your doctor allows you). Limit alcohol. Even if you're healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation. Don't smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation, deep breathing or meditation. Getting regular physical activity and plenty of sleep can help, too. Monitor your blood pressure at home. Medication: Take Schwabe’s Essentia Aurea/ thrice daily which is a cardio-tonic which helps in maintaining blood pressure, improves muscle tone of the heart and narrowing of blood vessels.
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My friend recently had a angioplasty done around 1 month back (01st Aug 2016) with 100% blockage (thrombosis) on RCA. He is on medication for blood thinner & Cholesterol ie Brilinta, Ecosprin & Storvas/Reva. He neither has diabetic nor hs hypertension. Also Dr. says he does not hv cholesterol. My Questions 1) Since angioplasty is done as such young age, will there be any cardio risk/problem in long run. Will he be able to live a normal life as he is a sports person 2) After the angioplasty, he has breathlessness & heaviness in his chest. Are these the side effects of the medicine that he take. Will he hv to continue for the medicine in entire life. 3) He hs started drinking Garlic & Ginger juice in the morning 1 teaspoon empty stomach, cut down on red meat & started consuming low fats oil. Will this reduce the medication 4) he hs started brisk walking (around 5k steps) exercise in morning & night (after dinner). Is this length of walk enough or should he increase his steps. Is that enough for losing weight n fat/ cholesterol? Detailed response against each point will be highly appreciated. Thanx -SQ-

MD - Homeopathy, BHMS
Homeopath, Kolkata
My friend recently had a angioplasty done around 1 month back (01st Aug 2016) with 100% blockage (thrombosis) on RCA....
Hello, I am giving your reply point wise in short. 1. There has a risk throughout the life even with medication. 2. Yes, this chemicals to be taken throughout life. 3. No juices, Please take 5/6 single cloved raw Garlic and 10gm raw Ginger with drinkable warm Water. 4. Walking for 45 minutes for 3 km is sufficient presently. Also go with pranayam morning and evening daily. Try to reduce the LDL n increase the HDL. Basically weight is the main reason for dysfunction of liver which causes production of bad cholesterol. Though it is not so much but instead of going to circulation it deposited to RCA or LCA. If agreed with, I will advise to take Homoeo medicine along with those chemicals as it will help you to be healthy by reducing the chemicals.
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I'm getting pain near my heart I've consulted many doctors. But there's no correct solution for my problem.

MBBS
General Physician, Cuttack
I'm getting pain near my heart I've consulted many doctors. But there's no correct solution for my problem.
1.For your age pain chest could be due to anxiety, stress, Physical and mental strain,hyper acidity, muscular problem 2. Avoid stress and strain 3.Do regular exercise, reduce your weight if over weight. 4.Control your diet. Avoid oily/spicy/fried and junk food,high calorie and cholesterol rich diet.Take small frequent meals(5-6 meals/day instead of three heavy meals).If you have hyper acidity take one tablet of pan 40 in the morning before breakfast daily for few days 5.Do Yoga, Meditation, deep breathing exercise like pranayama etc. It will calm your mind, control your emotion and relieve stress. 6.Have sound sleep for 7-8 hours daily. 7.Avoid smoking,alcohol, excess tea/coffee, if you are having 8. Drink plenty of water and take rest 9. Take paracetamol 500mg one tablet sos after food up to a maximum of three tablets per day at the time of chest pain 10.if you have recurrent attack of chest pain check your BP, take ECG and consult cardiologist 11.Consult me for further advice
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I am 25 year old boy from India. Last week I had chest pain, it lasted few minutes. Yesterday I again felt it. Is it symptom of heart disease?

C.S.C, D.C.H, M.B.B.S
General Physician,
I am 25 year old boy from India. Last week I had chest pain, it lasted few minutes. Yesterday I again felt it. Is it ...
Heart pain is associated with sweating and is like heaviness and compression in chest and you can take an ECG
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Which medicine is good for diabetes and bp now I am taking tenepride for diabetes and telapp 40 for bp I am also taking atocer 10.

Diploma in Diabetology, P.G. Diploma in Health Science (Diabetology), Certificate Course in Evidence based Diabetes Management -, MBBS
Endocrinologist, Thane
Which medicine is good for diabetes and bp now I am taking tenepride for diabetes and telapp 40 for bp I am also taki...
Dear lybrate-user, for treating diabetes, bp and cholesterol we've multiple drugs out of which your doctor will choose best for your age, sex and built. So there's nothing good or bad. Let your doctor take a call on that.
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My mother have problem of High pressure, sometimes she becomes angry and it also effect on her sleep, what should I do?

MBBS
General Physician, Delhi
My mother have problem of High pressure, sometimes she becomes angry and it also effect on her sleep, what should I do?
her problem appears to b stress induced high bp what r her b p readings what treatment is she taking?
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My cholestrol is high from a few months now. How can I reduce it.

DBCM (AM) General Physician
Alternative Medicine,
Try eatng lots of garlic. If you cant have it get it homeopathically allium sativum,(biochemic) nat phos. Avoid all types of fats and red meat and excessive salt consumption. Treatment is available, safe and without side effects in biochemic system of medication. Consult me in private.
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I'm 71 Years old. I am diabetic. My latest Hba1c level is 6. My total cholesterol is81. HDL is39. LDL is 32. I'm taking 1 tension 40, Rosufit 20, and metlor tablets daily. In view of low cholesterol level, do you advise me to take Rosufit?

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
I'm 71 Years old. I am diabetic. My latest Hba1c level is 6. My total cholesterol is81. HDL is39. LDL is 32. I'm taki...
Mr. Lybrate-user, looking at the levels mentioned you have too low lipids, so there is no need to take rosufit tablets. Thanks.
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I am suffering from dry cough for the last 2weeks and I have chest pain whenever I cough hard can you suggest what should be done?

MBBS
General Physician, Cuttack
I am suffering from dry cough for the last 2weeks and I have chest pain whenever I cough hard can you suggest what sh...
1. Do warm saline gurgling 3-4 times daily 2. Take viscodyne d syrup 2tsf thrice daily 3. You may have to take antibiotic along with it and carry out investigations including x ray of chest after consulting physician, if no relief4. Avoid smoking if you smoke.
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I am 25 years old. I have ldl cholesterol of 155. I have 169 cm height and weights only 57. How can I reduce cholesterol?

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
I am 25 years old. I have ldl cholesterol of 155. I have 169 cm height and weights only 57. How can I reduce choleste...
Take pranacharya medohar rasayn twice a day. Medohar guggul 2-2 twice a day. And pranacharya slim capsule 1-1 twice a day. .avoid junk food. Oily food. Fermented food. Alcohol consumption. Sugar.milk products and sweets. Take oats and cereals more. And do pranayama early in the morning and walk for atleast 45 minutes a day. And do exercises. Do not sleep immediately after taking meal.
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